The document discusses the Netherlands' approach to personalized medicine and health research. It outlines key principles of precision medicine including targeting the right drug, dose, and time for each patient. It also describes the Netherlands' national infrastructure supporting personalized medicine research through biobanks, clinical records, and other data sources. Mass spectrometry is highlighted as a technique enabling discovery of new glycoprotein biomarkers from human plasma samples.

1. Netherlands approach to personalized
medicine and health research
Prof Alain van Gool
Meeting World Economic Forum – Dutch Topsector LSH
The Hague, 7th March 2017

2. Source: Chakma, Journal of Young Investigators, 16, 2009
Principle of Precision Medicine
• The right drug for right patient at right dose at right time
• = Personalized medicine or Targeted medicine
2 Alain van Gool, The Hague, 7 March 2017

3. 3
Optimal Personalized / Precision / Targeted Medicine

4. Personalized health(care) model
Personalized
Intervention
of patients-like-me
Personal thresholds
of persons-like-me
Big
Biomarker
Data
Molecular
Non-molecular
Environment
…
HomeostasisAllostasisDisease
Time
Disease
Health
Selfmonitoring
Adapted from Jan van der Greef, TNO
Personal profile
Personalized health
Personalized medicine
4 Alain van Gool, The Hague, 7 March 2017

5. Internet of Personalized
Medicine&Health Data&Things
Biobanks, cohorts
Twitter data
Research
laboratory
MRI center
Wearables
Clinical records
Microscopy
facility
NL National Comprehensive Infrastructure for Personalized Medicine&Health Research

6. See Youtube – Health-RI
6 Alain van Gool, The Hague, 7 March 2017

7. Rich history of PPP in the Netherlands
(Centre for Translational Molecular Medicine) (Top Institute Pharma)
(BioMolecular Materials)
Public-private collaboration on diagnosis, drugs, devices (2006-2015)
7 Alain van Gool, The Hague, 7 March 2017

8. implementation
innovation
research
8 Alain van Gool, The Hague, 7 March 2017

9. Biomarker innovation gaps !
Discovery Clinical
validation/confirmation
Diagnostic
test
Number of
biomarkers
Gap 1
Gap 2
• Too much biomarker discovery
• Too little development to application
9 Alain van Gool, The Hague, 7 March 2017

10. Biomarker innovation gaps: some numbers
~ 5 biomarkers/
working day
1 biomarker/
1-3 years
1 biomarker/
2-10 years
Eg Biomarkers in time: Prostate cancer
May 2011: 2,231 biomarkers
Nov 2012: 6,562 biomarkers
Oct 2013: 8,358 biomarkers
Nov 2014: 10,350 biomarkers
Oct 2015: 11,856 biomarkers
14 Nov 2016: 14,481 biomarkers
Discovery Clinical
validation/confirmation
Diagnostic
test
Number of
biomarkers
Gap 1
Gap 2
10 Alain van Gool, The Hague, 7 March 2017

11. Choice for biomarker scientists: discover or confirm?
11 Alain van Gool, The Hague, 7 March 2017

12. European infrastructures
12 Alain van Gool, The Hague, 7 March 2017

13. PARTNERSHIP FOR DATA, TECHNOLOGIES & LEARNING

14. Ruben Kok
Barend Mons
Alain van Gool
Jaap Heringa
OVER 100 EXPERT GROUPS ALREADY INVOLVED

15. • Nijmegen, The Netherlands
• Mission: “To have a significant impact on healthcare”
• Strategic focus on Personalized Healthcare through
“the patient as partner”
• Core activities:
• Patient care
• Research
• Education
• 11.000 colleagues
• 52 departments
• 3.300 students
• 1.000 beds
Radboud university medical center
15
Radboud campus:
- Radboudumc
- Radboud University
- Hogeschool Arnhem Nijmegen
- Max Planck Institute
- Multiple companies

16. www.radboudumc.nl/research/technologycenters
Genomics
Bioinformatics
Animal
studies
Stem
cells
Translational
neuroscience
Image-guided
treatment
Imaging
Microscopy
Biobank
Health
economics
Mass
Spectrometry
Radboudumc
Technology
Centers
Investigational
products
Clinical
studies
EHR data
analysis
Statistics
Human
performance
Data
stewardship
Molecule
Flow
cytometry
3D lab
16

17. Advances in mass spectrometry
• Mass spectrometry analysis of glycoproteins in human plasma
• 1/20 microliter analysis: detection of 1.000.000 signals in one scan (1,4 Gb)
• ~40.000 peptides of which >80% contain sugar modification
• Potential to screen patients and identify new biomarkers?
500
1000
1500
2000
m/z
5 10 15 20 25 30 35 40 Time [min]
Proof of principle study:
Biomarkers !?
17 Alain van Gool, The Hague, 7 March 2017

18. Serum N-glycopeptide profiling as biomarker discovery
Comprehensive QC analytics

19. New diagnostic glycoprotein biomarker
• Glycoprofile of intact transferrin protein (80 kDa)
• Identified through combination glycoproteomics and exome sequencing
• Is linked to specific glycosylation disorders (rare metabolic diseases)
• Implemented now in clinical care as diagnostic mass spec test
19 Alain van Gool, The Hague, 7 March 2017

20. 20 Alain van Gool, The Hague, 7 March 2017
20
New data !
(generators, owners)

21. Exciting next steps: translate laboratory to society
• Point-of-care analysis of
few biomarkers
• 1.000.000 signals per
proteomics analysis
21 Alain van Gool, The Hague, 7 March 2017

22. 3 key aspects of personalized health(care)
‘I want to stay healthy. If not, how do I get healthy?’
1. What to measure?
2. How much can it change?
3. What should be the follow-up for me?
22 Alain van Gool, The Hague, 7 March 2017

23. Translation is key in Personalized Healthcare !
“I’m afraid you’re
suffering from an
increased IL-1β and
an aberrant miR843
expression”
Adapted from:
?
23 Alain van Gool, The Hague, 7 March 2017

24. Critical component in personalized healthcare: Data
• Data capture
• Data stewardship
• Data interpretation
• Data literacy
24 Alain van Gool, The Hague, 7 March 2017

25. Further joining forces in Netherlands
To drive personalized medicine & health research
25 Alain van Gool, The Hague, 7 March 2017

26. Health-RI Congress
1 December 2016
De Flint in Amersfoort
Register: www.nlhealthresearch.nl

27. Acknowledgements
Hans Wessels Jolein Gloerich
Roel Tans Esther Willems
Maurice van Dael Jenneke Keizer
Dirk Lefeber Monique van
Scherpenzeel
Leo Kluijtmans Ron Wevers
Marcel Verbeek Lucien Engelen
Jan Kremer Bas Bloem
Nathalie Bovy Paul Smits
the Radboudumc Technology Centers
and many others
www.radboudumc.nl/personalizedhealthcare
www.radboudumc.nl/research/technologycenters
www.radboudresearchfacilities.nl
alain.vangool@tno.nl
alain.vangool@radboudumc.nl
www.linkedIn.com
www.slideshare.net/alainvangool
Many collaborators and funders
Jan van der Greef Ben van Ommen
Ivana Bobeldijk Hans Princen
Lars Verschuren Marjan van Erk
Suzan Wopereis Heleen Wortelboer
Wessel Kraaij Ronald Mooi
Peter van Dijken Cyrille Krul
and many others
CarTarDis
Ruben Kok Barend Mons
Jaap Heringa Merlijn van Rijswijk
and many others
Anton Ussi Florence Bietrix
Laura Bermejo Andreas Scherer
Sulev Koks Marian Hajduch
Giovanni Migliaccio
and many others
27 Alain van Gool, The Hague, 7 March 2017